Individual
DR. EDWARD BALACI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
32-36 HARRISON ST, JOHNSON CITY, NY 13790-2122
(607) 729-1999
Mailing address
PO BOX 23, CANAJOHARIE, NY 13317-0023
(607) 729-2125
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
210748
NY
2085R0202X
Diagnostic Radiology Physician
Primary
210748
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01890968
—
NY
Enumeration date
03/08/2006
Last updated
04/27/2019
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